BRADY LEE PETERSON PAC
NPI 1619904554
Physician Assistant in Grand Rapids, MI

Q: What is Brady Peterson's NPI number?

The NPI number for Brady Peterson is 1619904554. It was assigned to this individual provider in the NPPES registry on June 27, 2006.

Q: What is Brady Peterson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Brady Peterson was last updated on February 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 27, 2006PECOS EnrolledAccepts Medicare Assignment

2900 BRADFORD ST NE, GRAND RAPIDS, MI 49525(616) 885-5000(616) 885-5020 Get Directions Write a Review

NPPES record last updated: February 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 25, 2021, Aug 21, 2017, Aug 23, 2016 (3 updates tracked since 2016).

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About Brady Lee Peterson Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADY LEE PETERSON PAC (NPI 1619904554) is an individual physician assistant in Grand Rapids, Michigan, licensed in Michigan (5601004582) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health United Hospital, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1619904554

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameBRADY LEE PETERSONCredential: PAC

Location Address2900 BRADFORD ST NEGrand Rapids, MI 49525-6427

Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560

Phone(616) 885-5000

Fax(616) 885-5020

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateJune 27, 2006

Last NPPES UpdateFebruary 25, 20213 updates tracked since enumeration

NPPES CertifiedFebruary 25, 2021

✔ NPI 1619904554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MI · 5601004582

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2900 BRADFORD ST NE, Grand Rapids, MI 49525

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brady Lee Peterson Pac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385641729

PECOS Enrollment IDI20061027000428

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

169 services165 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

92 services91 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

70 services69 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

28 services27 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

16 services16 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

15 services13 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Spectrum Health United Hospital

Acute Care Hospitals · Greenville, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230035

Location615 S Bower StreetGreenville, MI 48838 · Montcalm County

Birthing friendly

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230038

Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County

Emergency services Birthing friendly

Corewell Health Big Rapids Hospital

Acute Care Hospitals · Big Rapids, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230093

Location605 Oak StreetBig Rapids, MI 49307 · Mecosta County

Emergency services Birthing friendly

Corewell Health Ludington Hospital

Acute Care Hospitals · Ludington, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230110

LocationOne N Atkinson DriveLudington, MI 49431 · Mason County

Emergency services Birthing friendly

Corewell Health Pennock Hospital

Critical Access Hospitals · Hastings, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number231339

Location1009 W Green StHastings, MI 49058 · Barry County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49525 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MARK COLTON PA-C

Physician Assistant